Review of respiratory health status among World Trade Center workers and volunteers

Background and Objectives: Since 2002 the World Trade Center Medical Monitoring & Treatment Program (WTCMMTP) has assessed workers and volunteers for medical conditions related to their work at the World Trade Center (WTC) site. In the tenth anniversary of the attacks this literature review sought to summarize the early and most recent studies examining respiratory symptoms and respiratory conditions among WTC workers and volunteers.

Methods: Of the 37 articles published between 2002-2010 through the WTCMMTP, 18 articles assessed workers and volunteers for respiratory symptoms and conditions. Occupational health nurses from the WTCMMTP reviewed studies and summarized findings related to respiratory status.

Results: A high proportion of WTC workers and volunteers reported increased incidence or worsening of lower/upper respiratory symptoms after their work at the site. Spirometry results indicated increased obstruction and lower forced vital capacity. Risk factors for increased incidence or worsening of respiratory symptoms and poor spirometry results included early arrival to the WTC site and working at the pile of the collapsed towers. Workers and volunteers had increased incidence or worsening of the following conditions after WTC occupational exposure: Interstitial lung diseases, asthma, reactive airway dysfunction syndrome, chronic obstructive pulmonary disease, chronic rhinosinusitis, chronic nasopharyngitis, and chronic laryngitis.

Conclusion: WTC workers and volunteers are reporting new incidence or worsening of respiratory symptoms and conditions following work at the WTC site. No current data suggests increased incidence of pulmonary or upper airway cancers. Further monitoring is necessary to determine the long-term effects of this occupational health exposure.